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Cardiovascular diseases threaten the global health system and their prevalence among the incarcerated population poses a huge economic burden to governments. The purpose of this paper is to investigate the prevalence of cardiovascular disease risk factors among prisoners.

A systematic review was done on published studies that looked at prevalence and risk factors of cardiovascular disease among either male or female prisoners or both. PubMed, PubMed Central, Google scholar, Cochrane and Medline databases were searched from a period of 6 June 2016 to 23 June 2016. Quality assessment was done for all papers based on their methodology.

Online search yielded a total of 58,587 papers of which 43 were appropriately titled, but 21 were rejected based on their abstracts. Five of the studies could not be included because full texts were not available; 17 studies that met inclusion criteria in terms of abstracts and methodology were included in the study. Majority of the studies assessed weight (64.7 per cent), height (64.7 per cent), body mass index (64.7 per cent) and blood pressure (17.6 per cent) of inmates. Two of the studies used secondary data and one collected qualitative information via focus group discussions. Overall, prevalence of obesity (23.3 per cent), smoking (53.4 per cent) and physical inactivity (57.5 per cent) reported were high among prisoners.

Most of the studies were conducted in developed countries and this implies that there is a paucity of data in developing countries where prevalence of cardiovascular diseases is high. There is the need for more studies to be conducted in this area among developing countries.

This paper informs stakeholders on factors that put inmates at risk of cardiovascular diseases and can initiate timely interventions to be implemented within prisons.

The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.

A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.

Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.

To the best of the authors’ knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.

The purpose of this study was to evaluate the association of empirically derived dietary patterns with hypertension and hyperlipidemia among a large sample of Iranian industrial employees.

This cross-sectional study was done under the framework of Epidemiological Survey of Chronic Diseases on Manufacturing Employees. Major dietary patterns were derived based on a validated short form of food frequency questionnaire (FFQ) using exploratory factor analysis. Self-administered validated questionnaires were used to collect data on socio-demographic and job-related variables of participants. Multivariable logistic regression was applied for association analyses.

Higher levels of Western dietary pattern increased significantly the risk of hypertension (odds ratio [OR] = 1.85, 95% CI [1.36-2.53], P trend <0.001) and hyperlipidemia (OR = 1.45, 95% CI [1.16-1.81], p = 0.001) even after controlling for confounding variables. The traditional dietary pattern was marginally associated with a significant increase in risk of hyperlipidemia ( = 1.14, 95% CI [0.92-1.41], p = 0.084) in the fully adjusted model. However, higher levels of healthy dietary pattern were significantly associated with a decreased risk of hyperlipidemia in the final model (OR 0.80, 95% CI [0.64-0.90], p = 0.025).

To the authors’ knowledge, an association analysis between dietary patterns and major cardiovascular disease risk in workforce population over the world is scarce and has not yet been conducted among Iranian industrial employees. This study’s findings are especially relevant for the industrial workforce population because they are at high risk of other job-related risks that increase the CVD risk.

Smoking rates are known to be higher amongst those committed to prison than the general population. Those in prison suffer from high rates of comorbidities that are likely to increase their risk of cardiovascular disease (CVD), making it more difficult to manage. In 2016, a tobacco ban began to be implemented across prisons in England and Wales, UK. This study aims to measure the effect of the tobacco ban on predicted cardiovascular risk for those quitting smoking on admission to prison.

Using data from a prevalence study of CVD in prisons, the authors have assessed the effect of the tobacco ban on cardiovascular risk, using predicted age to CVD event, ten-year CVD risk and heart age, for those who previously smoked and gave up on admission to prison.

The results demonstrate measurable health gains across all age groups with the greatest gains found in those aged 50 years and older and who had been heavy smokers. Quitting smoking on admission to prison led to a reduced heart age of between two and seven years for all participants.

The data supports tobacco bans in prisons as a public health measure to reduce risk of CVD. Interventions are needed to encourage maintenance of smoking cessation on release from prison for the full health benefits to be realised.

While cardiovascular disease (CVD) is the leading cause of death globally, over 80% of the cases could be prevented through early lifestyle changes. From the perspective of quality management in healthcare, this may offer an effective prevention window if modifiable CVD risk factors are identified and treated in adolescence. The purpose of this research is to examine the negative emotions in adolescents and determine if it independently increases CVD risk later in life.

Longitudinal data from 12,350 participants of the Add Health study, which conducted a multi-wave survey for 14 years from adolescence (Wave 1) through adulthood (Wave 4), were used to test the research hypothesis. Four items (perception of life, self-reported depression, perceived loneliness and fearfulness) reflective of adolescent negative emotion were identified from the Wave 1 questionnaire, and factor analysis was conducted to confirm the hypothesized structure. The outcome variable, 30-year adulthood CVD risk category (high or low risk), was estimated using biomarkers, biological data and other factors collected during the 14-year follow-up in Wave 4. A logistic regression analysis was employed to assess the impact of adolescent negative emotions on adulthood CVD risk after adjusting for common risk factors such as sociodemographic characteristics, socioeconomic status and medical conditions in adolescence.

The results indicated adolescent negative emotion to be significantly associated with CVD risk category (p-value < 0.0001), even after controlling for common risk factors. A unit increase in the level of adolescent negative emotion increased the chance of being in the high CVD risk group in adulthood by 8% (odds ratio = 1.08 ± 0.03).

Healthcare providers and organizations could capitalize on the research findings by screening for negative emotions early in life through individual and societal interventions. The findings also provide an opportunity for implementing quality improvement initiatives to deliver robust preventive care, which, in turn, could improve the overall population health, reduce healthcare costs and improve care quality.

Although previous studies showed a strong link between adolescent physiological factors (e.g. obesity) and adulthood cardiovascular disease (CVD), the association between adolescent outlook/attitude (negative emotion) and CVD risk has not been examined.

Prisoners have an increased risk of cardiovascular disease (CVD) compared to the general population. Knowledge and risk perception of CVD can influence engagement in preventative behaviours that lower an individual’s CVD risk. This paper aims to explore prisoners’ knowledge of CVD, and prisoners and staff’s perceptions of prisoners’ CVD risk.

This was a qualitative study in which semi-structured interviews were conducted with 16 prisoners and 11 prison and National Health Services staff in a Scottish prison. Data were analysed thematically using the framework method.

Most prisoners had limited knowledge of CVD as they could not describe it or could only identify one or two risk factors or cardiovascular events. Both prisoners and staff viewed prisoners’ CVD risk as either pertaining to one individual, or pertaining to the general prisoner population. Unhealthy behaviours that were believed to increase CVD risk were linked to three perceived consequences of imprisonment: mental health problems, boredom and powerlessness.

To the best of the authors’ knowledge, this is the first study to explore the CVD knowledge of prisoners, and perceptions of CVD risk from the perspectives of prisoners and prison staff. Findings from this study indicate that CVD education needs to be a priority for prisoners, addressing knowledge of CVD, its risk and risk perceptions. Additionally, the findings indicate that individual and socio-environmental factors linked to prisoners’ CVD risk need to be targeted to reduce this risk. Future research should focus on socio-environmental interventions that can lead to reducing the CVD risk of prisoners.

The purpose of this paper is to evaluate the association between food consumption classified by the degree of processing and cardiometabolic risk factors in a population at risk of cardiovascular disease.

A cross-sectional study conducted with 325 adults and elderlies who present a cardiovascular risk factor. The food consumption was evaluated by a 24 h dietary recall, and it was classified according to the NOVA classification.

Individuals who presented a higher consumption of processed and ultra-processed food had a higher prevalence of abdominal obesity, waist/hip ratio (PR = 1.005; p-value = 0.049), waist circumference (PR = 1.003; p-value = 0.02) and high total cholesterol (PR = 1.008; p-value = 0.047), while ultra-processed had a higher prevalence of excess weight (PR = 1.004; p-value = 0.04), and abdominal obesity, waist/hip ratio (PR = 1.005; p-value = 0.04), waist circumference (PR = 1.004; p-value = 0.004) and waist/height ratio (PR = 1.003; p-value = 0.03).

An association was found between the degree of food processing and cardiometabolic risk factors, even in a population that already has a risk factor for cardiovascular disease, reinforcing the importance of personalized nutrition orientation that considers the profile of the target population as well as types of meals.

Food processing in itself can influence cardiometabolic risk and, as far as is known, no study has evaluated food processing in individuals who already have some type of cardiovascular risk. Also, consumption was assessed by the degree of processing between meals.

The associations between legume consumption and cardiovascular events (CVEs) have extensively been studied. However, there are few studies that considered longitudinal association between legume consumption (with repeated measurements across time) and CVEs in low-income countries where legume consumption is lower than the Western countries. The authors aimed to investigate the long-term longitudinal relationship between soybean, non-soybean and overall legume consumption and CVEs using repeated measures of legumes and time-varying confounders in a cohort study of the general population.

The current study was performed within the framework of the Isfahan cohort study among 5,432 healthy participants. The participants were followed-up for fatal and non-fatal myocardial infarction, unstable angina, fatal and non-fatal stroke and sudden cardiac death for 13 years. Dietary intake was evaluated using a validated food frequency questionnaire in 2001, 2007 and 2013. The hazard ratios (HRs) and 95% confidence intervals (CI) for CVEs between categories of soybean, non-soybean and overall legumes intake were examined using marginal Cox's regression analysis.

Long-term consumptions of overall legumes more than three times per week and non-soybean three times or more per week compared with those who had less than once a week were associated with 19.5% (HR = 0.805, 95% CI: 0.650,0.998; p < 0.048) and a 18.5% (HR = 0.815, 95% CI: 0.673, 0.988; p < 0.037) lower risk of CVEs in the general population, respectively. However, our findings revealed no significant reduction in CVEs following a higher intake of soybeans.

In the long run, even modest consumption of legumes, but not soybeans alone, can be effective to reduce CVEs risk in a low-income population. Further studies are warranted to confirm our results in other populations, examine the associations by the type of cardiovascular events and determine any possible threshold effects in this regard.

Prior research suggests that 80% of cardiovascular disease (CVD) events can be prevented by modifying certain behaviors, yet it remains the primary cause of mortality worldwide. Early detection and management of critical modifiable factors have the potential to improve cardiovascular care quality as well as the associated health outcomes. This study aims to assess the independent impact of psychological well-being in adolescence, a modifiable factor, on long-term CVD risk and promote targeted early interventions through quality management principles.

Data from the Add Health study, which employed a series of surveys and health tests (Wave 1 – Wave 4) on individuals for 14 years (from adolescence to adulthood), were obtained and analyzed longitudinally. Psychological well-being in adolescence was assessed using four Wave 1 survey questions, and 30-year CVD risk was estimated 14 years later with Wave 4 data. Three different logistic regression models were examined to understand the impact of adding covariates.

This study’s sample included 12,116 individuals who responded to all the relevant questions and underwent clinical risk factor measurements in Wave 1 (adolescence) and Wave 4 (young adulthood). Psychological well-being was protective with reduced risk for CVD across the three models tested. There is a statistically significant association, where increasing psychological well-being reduced the 30-year CVD risk exponentially in all the models. The analysis also suggested an exposure–response relationship, where the 30-year risk category of adulthood CVD decreased with an increase in psychological well-being.

This research uncovers an inverse association between adolescent psychological well-being and adulthood CVD risk. This study also identifies quality management-based preventive tools/techniques to improve psychological well-being in adolescence and therefore reduce CVD risk later in life.

This study is among the first to establish a long-term association between positive well-being and CVD risk. Also, unlike the existing literature, this work provides implications for improving CVD care from a quality management perspective.

Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side‐effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year.

A physical health monitoring sheet was introduced in all the patients' records on a 15‐bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re‐audit were compared.

At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re‐audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status.

This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward.

There is a need for improved access to physical health care in long‐stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients.

Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.